With little apparent effort, she also hearkens to the rich resonance modern science has sounded between human and planetary health.

The approach traffics heavily in complex systems, common sense and fun.

The Center for Sustainable Medicine, which Pershouse directs, strives to bring greater harmony between a body’s behavior, diet and emotional life; between microscopic constituents and a body’s place in the immediate (and broader) community.

Those complementary elements of health and environmental activism, she says, have for too long been ignored.

Too intellectual for you?

She tosses this out: a session with a client at the clinic might include (depending on the symptoms) massage and a prescription for greater community engagement, eggs-Benedict, plenty of butter and grass-fed beef.

Under the center’s same roof, in what she terms “a living experiment,” Pershouse raises her two teenage boys. She hosts classes for Upper Valley residents who want to bolster their role in civic discourse.

Her research is guided by a theory that the web of life must be constantly re-recognized, renewed and nourished.

Home remedies

Pershouse, 50, serves on the town conservation commission and is a prominent advocate in Thetford for outdoor education and the extension of legal rights to ecosystems, particularly those which humans have degraded.

“My work with people’s specific bodies is very similar to what I’m looking at in the outer world. My attention has been drawn to both,” she said. “Everything has to do with everything: That’s my motto.”

Pershouse has nearly finished a book (working title: “Sustainable Medicine: Re-imagining Care with Our Inner and Outer Ecosystems in Mind”). The book traces the common threads that knit together her practice, her family life as a single mother, her family’s history as pioneers in neurosurgery and radiation.

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The subtext: Rapid climate change, within us and without us, poses a whopping health challenge to us all.

The book in anchored in Pershouse’s clinic and house, where she explores what she calls “a fertile way of practicing medicine, versus one that is separate, controlled and sterile.”

The goal might sound lofty, but she insists that the benefits of her approach are practical.

“We have lots of tools that we’re not using in medicine because we’re fascinated and enamored with medical technology,” she said.

That technology literally comes at the expense of other cures.

“Why should anyone be making billions of dollars off of something that’s supposed to be caring about people?” she asked. “It skews the system toward unnecessary care and unnecessary drugs.”

Second opinion

Among the more generous healing traditions that guide her are the observations of Hildegaard of Bingen, who in 12th century Germany wrote extensively about the body as a garden. Similarly, she traces the corporeal landscape of meridians, rivers and streams that inform traditional Chinese medicine.

She brings local wisdom to those academic conceits. She endorses the harvest of venison as well as vegetables (she says she’ll consider taking up hunting once she’s developed sufficient marksmanship to cleanly kill a deer).

She extends healthful-current status to the Ompompanoosuc River that runs behind her home/clinic, and in which she takes regular dips — spring, summer and fall.

Long run

Pershouse is not a natural-born nature child. She grew up in Cambridge, Mass., immersed in the culture of Western medicine.

Annual visits to relatives in Keene Valley, N.Y., and weekends in Warner, N.H., provided “avenues of escape,” she said.

While in her 20s, she moved to Manhattan to work at New York Magazine.

“I was there for five years, with three smokers in a very small room with windows that didn’t open,” Pershouse remembers.

Frustrated by the unhealthy environment — and by her doctors’ inability to “heal” her, she explored alternatives.

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Pershouse ended up in Seattle, teaching yoga and going to school for acupuncture and Chinese herbal medicine.

“Since then, I’ve come to understand that the body is its own ecosystem,” she said. “Everything in nature, including the human body, has its own laws, rules, and principles.

“If you follow those rules, you can restore health, both in your own inner ecosystem and in the larger ecosystem that we are part of,” Pershouse added.

Her goal: a “permaculture” of healthcare, which, like its agricultural namesake, emphasizes long-term productivity.

Macro-scope

Pershouse’s grasp of planetary healthcare has been shaped by weather extremes and flooding she has witnessed in 20 years as a Vermonter.

“My big ‘aha!’ over the past couple of years has been understanding the dynamics of climate change, which is not just about things getting warmer,” she said. “It’s about moisture and air flow: how moisture in the atmosphere moves around the globe. And it has shifted dramatically.”

She elaborated:

“It turns out that a lot of climate change is related to desertification — the loss of microorganisms that create healthy topsoil and plants. Plants naturally take CO2 out of the atmosphere and break it down into oxygen and carbon. As the plants go through their life cycle, they store the carbon safely back in the soil.”

Gut instinct

As described in Chinese medicine, society at large — and each human’s health — thrives in dynamism, but suffers through wild fluctuations and resource depletion.

The metaphor hews to natural phenomena: flow and currents; wind and still; dampness and dryness; heat and cold; earth and fire.

“The digestive system is known as the earth/soil element. Which is so cool, because it is literally our topsoil — where micro-organisms live.”

The theme stokes Pershouse.

Her enthusiasm is likely to build as scientists define the human body, with ever-greater precision, as a “microbiome” — a habitat awash with miniscule organisms, rather than as a discrete entity.

“That ecosystem has everything to do with our physical and emotional health,” she said. “Their habitat is actually our habitat. It’s all one system, perfectly adapted to support us and everything around us.

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“We would not be human without the inner ecosystem that we carry within us,” Pershouse continued. “Ninety percent of our cells are ‘non-human’ microorganisms, which we depend on for brain development, immunity and more basic things like digestion.”

“They’re not ‘foreign bodies,” she added. “They are part of us, just like the soil microorganisms are an essential part of the land.”

Brimming with microbes

The earthy comparison continues: Soil, deprived of its constituent organisms through over-assertive agriculture, mirrors the “sterility of the gut” in a patient rendered hyper-vulnerable to infection through an excess of antibiotics.

“Farming, food, and medicine are all on a continuum,” she said. “Care for the land and care for our bodies are essentially the same practice. We think we are separate from nature but we are nature itself. It’s a fuzzy line between our inner and outer ecosystems.”

A preventative remedy: the re-introduction of micro-organisms through “probiotic” foods.

Lacto-fermented chow like saurkraut and kimchi and kefir, Pershouse enthuses, “are just brimming with good bacteria” — and so are we, if we know what’s good for us.

Tendrils

Pershouse’s community activism, likewise, seeks deep roots.

Over the past year, her health center has hosted a series of classes for about 20 local community leaders (and those who aspire to leadership). Participants seek to be more effective in social change, and to develop greater resilience as they encounter challenges.

The emphasis of HEART (Health, Empowerment And Resiliency Training) is on “deep self-care and peer support,” she said — the sort that plumbs every facet of a person’s life.

Broader discussions of dietary health, for instance, include the history of industrial versus sustainable agriculture, “so people can see their own health in the context of social change and the environment.”

Also on the syllabus: lessons in making probiotic sauerkraut, discussions about overcoming addictions, instruction in meditation — and their parallels in nominally non-human systems.

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A recurring question: What are forms of exercise that can become integrated into daily life?

“If we’re really living properly, we should be getting the exercise we need through the work that we do and through our play,” Pershouse answers. “A fairly short (and wild) game of tag with your kids, a couple days a week — can give you a better aerobic workout than jogging.”

The investment in family time yields a lower carbon footprint than a trip to the gym.

Similarly, she believes that the value of human touch outweighs that of an overstocked medicine cabinet.

Her HEART course expands the definition of a healthy family to include peer-support networks and “deep-listening” skills that underpin effective group work.

She asks her clients a question fundamental to any diagnosis: “What gets in your way of taking charge of things that you would like to see changed — both in your own life, and out in your community?’”

Upside down

A substantial part of Pershouse’s upcoming book explores how American society might find more effective avenues to health and environmental fitness.

“What we think of as healthcare only contributes 10 percent to our overall health outcomes, according to the World Health Organization,” she writes. “Other things, like lifestyle choices, environment, and biology are the other 90 percent. In the public health world, they’ve figured that out.”

Plenty of other countries have better health outcomes for a fraction of our healthcare costs, and a fraction of the impact on the environment, she said.

Our mainstream medicine, on the other hand, has inflated its own importance, she believes — and advocates caution when yet another energy-intensive treatment is unveiled.

“Hospitals, even so-called sustainable ones, by their own measurements, have a huge impact on climate. There are lots and lots of amazing things we can do with high-tech, fossil-fuel-based healthcare,” Pershouse said. “But every dollar we spend on it contributes directly to climate change: resource depletion, environmental degradation, and loss of clean water supplies.”

“A stable climate and a functioning ecosystem are all essential to health and survival,” she added. “If we’re going to choose a high-tech treatment, we have to be damn sure that we really need it.”